But if the remedy found to be the homoeopathic specific for a
prevalent epidemic of intermittent fever do not effect a perfect cure in some one or other
patient, if it be not the influence of a marshy district that prevents the cure, it must
always be the psoric miasm in the background, in which case antipsoric medicines must be
employed until complete relief is obtained.

Epidemics of intermittent fever, in situations where none are
endemic, are of the nature of chronic diseases, composed of single acute paroxysms; each
single epidemic is of a peculiar, uniform character common to all the individuals
attacked, and when this character is found in the totality of the symptoms common to all,
it guides us to the discovery of the homoeopathic (specific) remedy suitable for all the
cases, which is almost universally serviceable in those patients who enjoyed tolerable
health before the occurrence of the epidemic, that is to say, who were not chronic
sufferers from developed psora.

If, however, in such an epidemic intermittent fever the first
paroxysms have been left uncured, or if the patients have been weakened by improper
allopathic treatment; then the inherent psora that exists, alas! in so many persons,
although in a latent state, becomes developed, takes on the type of the intermittent
fever, and to all appearance continues to play the part of the epidemic intermittent
fever, so that the medicine, which would have been useful in the first paroxysms (rarely
an antipsoric), is now no longer suitable and cannot be of any service. We have now to do
with a psoric intermittent fever only, and this will generally be subdued by minute and
rarely repeated doses of sulphur or hepar sulphuris in a high potency.

In those often very pernicious intermittent fevers which attack a
single person, not residing in a marshy district, we must also at first, as in the case of
acute diseases generally, which they resemble in respect to their psoric origin, employ
for some days, to render what service it may, a homoeopathic remedy selected for the
special case from the other class of proved (not antipsoric) medicines; but if,
notwithstanding this procedure, the recovery is deferred, we know that we have psora on
the point of its development, and that in this case antipsoric medicines alone can effect
a radical cure.

The intermittent fevers endemic in marshy districts and tracts of
country frequently exposed to inundations, give a great deal of work to physicians of the
old school, and yet a healthy man may in his youth become habituated even to marshy
districts and remain in good health, provided he preserves a faultless regimen and his
system is not lowered by want, fatigue or pernicious passions. The intermittent fevers
endemic there would at the most only attack him on his first arrival; but one or two very
small doses of a highly potentized solution of cinchona bark would, conjointly with the
well-regulated mode of living just alluded to, speedily free him from the disease. But
persons who, while taking sufficient corporeal exercise and pursuing a healthy system of
intellectual occupations and bodily regimen, cannot be cured of marsh intermittent fever
by one or a few of such small doses of cinchona - in such persons psora, striving to
develop itself, always lies at the root of their malady, and their intermittent fever
cannot be cured in the marshy district without antipsoric treatment.1
It sometimes happens that when these patients exchange, without delay, the marshy district
for one that is dry and mountainous, recovery apparently ensues (the fever leaves them) if
they be not yet deeply sunk in disease, that is to say, if the psora was not completely
developed in them and can consequently return to its latent state; but they will never
regain perfect health without antipsoric treatment.

1

Large, oft-repeated doses of cinchona bark, as also
concentrated cinchona remedies, such as the sulphate of quinine, have certainly the power
of freeing such patients from the periodical fits of the marsh ague; but those thus
deceived into the belief that they are cured remain diseased in another way.

The intermittent fevers endemic in marshy districts and tracts of
country frequently exposed to inundations, give a great deal of work to physicians of the
old school, and yet a healthy man may in his youth become habituated even to marshy
districts and remain in good health, provided he preserves a faultless regimen and his
system is not lowered by want, fatigue or pernicious passions. The intermittent fevers
endemic there would at the most only attack him on his first arrival; but one or two very
small doses of a highly potentized solution of cinchona bark would, conjointly with the
well-regulated mode of living just alluded to, speedily free him from the disease. But
persons who, while taking sufficient corporeal exercise and pursuing a healthy system of
intellectual occupations and bodily regimen, cannot be cured of marsh intermittent fever
by one or a few of such small doses of cinchona - in such persons psora, striving to
develop itself, always lies at the root of their malady, and their intermittent fever
cannot be cured in the marshy district without antipsoric treatment.1
It sometimes happens that when these patients exchange, without delay, the marshy district
for one that is dry and mountainous, recovery apparently ensues (the fever leaves them) if
they be not yet deeply sunk in disease, that is to say, if the psora was not completely
developed in them and can consequently return to its latent state; but they will never
regain perfect health without antipsoric treatment.

1

Large, oft-repeated doses of cinchona bark, as also
concentrated cinchona remedies, such as the sulphate of quinine, have certainly the power
of freeing such patients from the periodical fits of the marsh ague; but those thus
deceived into the belief that they are cured remain diseased in another way, frequently
with an incurable Quinin intoxication (see §276 note.)

Having thus seen what attention should, in the homoeopathic treatment,
be paid to the chief varieties of diseases and to the peculiar circumstances connected
with them, we now pass on to what we have to say respecting the remedies and the mode of
employing them, together with the diet and regimen to be observed during their use.

Having thus seen what attention should, in the homoeopathic treatment,
be paid to the chief varieties of diseases and to the peculiar circumstances connected
with them, we now pass on to what we have to say respecting the remedies and the mode of
employing them, together with the diet and regimen to be observed during their use.

Every perceptibly progressive and strikingly increasing amelioration in
a transient (acute) or persistent (chronic) disease, is a condition which, as long as it
lasts, completely precludes every repetition of the administration of any medicine
whatsoever, because all the good the medicine taken continues to effect is new hastening
towards its completion. Every new dose of any medicine whatsoever, even of the one last
administered, that has hitherto shown itself to be salutary, would in this case disturb
the work of amelioration.

On the other hand, the slowly progressive amelioration consequent on a
very minute dose, whose selection has been accurately homoeopathic, when it has met with
no hindrance to the duration of its action, sometimes accomplishes all the good the remedy
in question is capable from its nature of performing in a given case, in periods of forty,
fifty or a hundred days. This is, however, but rarely the case; and besides, it must be a
matter of great importance to the physician as well as to the patient that were it
possible, this period should be diminished to one-half, one-quarter, and even still less,
so that a much more rapid cure might be obtained. And this may be very happily affected,
as recent and oft-repeated observations have shown, under three conditions: firstly, if
the medicine selected with the utmost care was perfectly homoeopathic; secondly, if it was
given in the minutest dose, so as to produce the least possible excitation of the vital
force, and yet sufficient to effect the necessary change in it; and thirdly, if this
minutest yet powerful dose of the best selected medicine be repeated at suitable
intervals,1 which experience shall have pronounced to be the best
adapted for accelerating the cure to the utmost extent, yet without the vital force, which
it is sought to influence to the production of a similar medicinal disease, being able to
feel itself excited and roused to adverse reactions.

1

In the former editions of the Organon I have advised that a
single dose of a well-selected homoeopathic medicine should always be allowed first fully
to expend its action before a new medicine is given or the same one repeated - a doctrine
which was the result of the positive experience that neither by a larger dose of the
remedy, which may have been well chosen (as has been again recently proposed, but which
would be very like a retrograde movement), nor, what amounts to the same thing, by several
doses of it given in quick succession, can the greatest possible good be effected in the
treatment of diseases, more especially of chronic ones; and the reason of this is, that by
such a procedure the vital force dose not quietly adapt itself to the transition from the
natural disease to the similar medicinal disease, but is usually so violently excited and
disturbed by a larger dose, or by smaller doses of even a homoeopathically chosen remedy
given rapidly one after the other, that in most cases its reaction will be anything but
salutary and will do more harm than good. As long as no more efficacious mode of
proceeding than that then taught by me was discovered, the safe philanthropic maxim of sin
non juvat, modo ne noceat, rendered it imperative for the homoeopathic practitioner, for
whom the weal of his fellow-creatures was the highest object, to allow, as a general rule
in diseases, but a single dose at a time, and that the very smallest, of the carefully
selected remedy to act upon the patient and, moreover, to exhaust its action. The very
smallest, I repeat, for it holds good and will continue to hold good as a homoeopathic
therapeutic maxim not to be refuted by any experience in the world, that the best doses of
the properly selected remedy is always the very smallest on in one of the high potencies
(X), as well for chronic as for acute as for acute diseases - a truth that is the
inestimable property of pure homoeopathy and which as long as allopathy and the new
mongrel sect, whose treatment is a mixture of allopathic and homoeopathic processes is not
much better continues to gnaw like a cancer at the life of sick human beings, and to ruin
them by large and ever larger doses of drugs, will keep pure homoeopathy separated from
these spurious arts as by an impassable gulf.

On the other hand, however, practice shows us that though a single one
of these small doses may suffice to accomplish almost all that it was possible for this
medicine to do under the circumstances, in some, and especially in slight cases of
disease, particularly in those of young children and very delicate and excitable adults,
yet that in many, indeed in most cases, not only of very chronic diseases that have
already made great progress and have frequently been aggravated by a previous employment
of inappropriate medicines, but also of serious acute diseases, one such smallest dose of
medicine in our highly potentized dynamization is evidently insufficient to effect all the
curative action that might be expected from that medicine, for it may unquestionably be
requisite to administer several of them, in order that the vital force may be
pathogenetically altered by them to such a degree and its salutary reaction stimulated to
such a height, as to enable it to completely extinguish, by its reaction, the whole of
that portion of the original disease that it lay in the power of the well-selected
homoeopathic remedy to eradicate; the best chosen medicine in such a small dose, given but
once, might certainly be of some service, but would not be nearly sufficient.

But the careful homoeopathic physician would not venture soon to repeat
the same dose of the same remedy again, as from such a practice he has frequently
experienced no advantage, but most frequently, on close observation, decided disadvantage.
He generally witnessed aggravation, from even the smallest dose of the most suitable
remedy, which he has given one day, when he repeated the next day and the next.

Now, in cases where he was convinced of the correctness of his choice
of the homoeopathic medicine, in order to obtain more benefit for the patient than he was
able to get hitherto from prescribing a single small dose, the idea often naturally struck
him to increase the dose, since, for the reason given above, one single dose only should
be given; an, for instance, in place of giving a single very minute globule moistened with
the medicine in the highest dynamization, to administer six, seven or eight of them at
once, and even a half or a whole drop. But the result was almost always less favourable
than it should have been; it was often actually unfavourable, often even very bad - an
injury that, in a patient so treated, is difficult to repair.

The difficulty in this case is not solved by giving, instead, lower
dynamizations of the remedy in a large dose.

Thus, increasing the strength of the single doses of the homoeopathic
medicine with the view of effecting the degree of pathogenic excitation of the vital force
necessary to produce satisfactory salutary reaction, fails altogether, as experience
teaches, to accomplish the desired object. This vital force is thereby too violent and too
suddenly assailed and excited to allow it time to exercise a gradual equable, salutary
reaction, to adapt itself to the modification effected in it; hence it strives to repel,
as if it were an enemy, the medicine attacking it in excessive force, by means of
vomiting, diarrhoea, fever, perspiration, and so forth, and thus in a great measure it
diverts and renders nugatory the aim of the incautious physician - little or no good
towards curing the disease will be thereby accomplished; on the contrary, the patient will
be thereby perceptibly weakened and, for a long time, the administration of even the
smallest dose of the same remedy must not be thought of if we would not wish it to injure
the patient.

But it happens, moreover, that a number of the smallest doses given for
the same object in quick succession accumulate in the organism into a kind of excessively
large dose, with (a few cases excepted) similar bad results; in this case the vital force,
not being able to recover itself betwixt every dose, though it be but small, becomes
oppressed and overwhelmed, and thus being incapable of reacting in a salutary manner, it
is necessitated passively to allow involuntary the continuance of the over-strong
medicinal disease that has thus been forced upon it, just in the same manner as we may
every day observe from the allopathic abuse of large cumulative doses of one and the same
medicine, to the lasting injury of the patient.

Now, therefore, in order, whilst avoiding the erroneous method I have
here pointed out, to attain the desired object more certainly than hitherto, and to
administer the medicine selected in such a manner that it must exercise all its efficacy
without injury to the patient, that it may effect all the good it is capable of performing
in a given case of disease, I have lately adopted a particular method.

I perceived that, in order to discover this true middle path, we must
be guided as well by the nature of the different medicinal substances, as also by the
corporeal constitution of the patient and the magnitude of the disease, so that - to give
an example from the use of sulphur in chronic (psoric) diseases - the smallest dose of it
(tinct, sulph. X°) can seldom be repeated with advantage, seen in the most robust
patients and in fully developed psora, oftener than every seven days, a period of time
which must be proportionally lengthened when we have to treat weaker and more excitable
patients of this kind; in such cases we would do well to give such a dose only every nine,
twelve, or fourteen days, and continue to repeat the medicine until it ceases to be of
service. We thus find (to abide by the instance of sulphur) that in sporic diseases seldom
fewer than four, often however, six, eight and even ten doses (tinct. sulph. X°) are
required to be successively administered at these intervals for the complete annihilation
of the whole portion of the chronic disease that is eradicated by sulphur - provided
always there had been no previous allopathic abuse of sulphur in the case. Thus even a
(primary) scabious eruption of recent origin, though it may have spread all over the body,
may be perfectly cured, in persons who are not too weakly, by a dose of tinct sulph. X°
given every seven days, in the course of from ten to twelve weeks (accordingly with ten or
twelve such globules), so that it will seldom be necessary to aid the cure with a few
doses of carb. veg. X° (also given at the rate of one dose per week) without the
slightest external treatment besides frequent changes of linen and good regimen.

When for other serious chronic diseases also we may consider it
requisite, as far as we can calculate, to give eight, nine or ten doses of tinct. sulph.
(at X°) it is yet more expedient in such cases, instead of giving them in uninterrupted
succession, to interpose after every, or every second or third dose, a dose of another
medicine, which in this case is next in point of homoeopathic suitableness to sulphur
(usually hep. sulph.) and to allow this likewise to act for eight, nine, twelve or
fourteen days before again commencing a course of three doses of sulphur.

But it not infrequently happens that the vital force refuses to permit
several doses of sulphur, even though they may be essential for the cure of the chronic
malady and are given at the intervals mentioned above, to act quietly on itself; this
refusal it reveals by some, though moderate, sulphur symptoms, which it allows to appear
in the patient during the treatment. In such cases it is sometimes advisable to administer
a small dose of nux vom. X°, allowing it to act for eight or ten days, in order to
dispose the system again to allow succeeding doses of the sulphur to act quietly and
effectually upon it. In those cases for which it is adapted, puls. X° is preferable.

But the vital force shows the greatest resistance to the salutary
action upon itself of the strongly indicated sulphur, and even exhibits manifest
aggravation of the chronic disease, though the sulphur be given in the very smallest dose,
though only a globule of the size of a mustard seed moistened with tinct. sulph X° be
smelt, if the sulphur have formerly (it may be years since) been improperly given
allopathically in large doses. This is one lamentable circumstance that renders the best
medical treatment of chronic disease almost impossible among the many that the ordinary
bungling treatment of chronic diseases by the old school would leave us nothing to do but
to deplore, were there not some mode of getting over the difficulty.

In such cases we have only to let the patient smell a single time
strongly at a globule the size of a mustard seed moistened with mercur metall. X, and
allow this olfaction to act for about nine days, in order to make the vital force again
disposed to permit the sulphur (at least the olfaction of tinct. sulph. X°) to exercise a
beneficial influence on itself - a discovery for which we are indepted to Dr. Griesselich,
of Carlsruhe.

Every perceptibly progressive and strikingly increasing amelioration
during treatment is a condition which, as long as it lasts, completely precludes every
repetition of the administration of any medicine whatsoever, because all the good the
medicine taken continues to effect is now hastening towards its completion. This is not
infrequently the cause in acute diseases, but in more chronic diseases, on the other hand,
a single dose of an appropriately selected homoeopathic remedy will at times complete even
with but slowly progressive improvement and give the help which such a remedy in such a
case can accomplish naturally within 40, 50, 60, 100 days. This is, however, but rarely
the case; and besides, it must be a matter of great importance to the physician as well as
to the patient that were it possible, this period should be diminished to one-half,
one-quarter, and even still less, so that a much more rapid cure might be obtained. And
this may be very happily affected, as recent and oft-repeated observations have taught me
under the following conditions: firstly, if the medicine selected with the utmost care was
perfectly homoeopathic; secondly, if it is highly potentized, dissolved in water and given
in proper small dose that experience has taught as the most suitable in definite intervals
for the quickest accomplishment of the cure but with the precaution, that the degree of
every dose deviate somewhat from the preceding and following in order that the vital
principle which is to be altered to a similar medicinal disease be not aroused to untoward
reactions and revolt as is always the case1 with unmodified and
especially rapidly repeated doses.

1

What I said in the fifth edition of the organon, in a long
note to this paragraph in order to prevent these undesirable reactions of the vital
energy, was all the experience I then had justified. But during the last four or five
years, however, all these difficulties are wholly solved by my new altered but perfected
method. The same carefully selected medicine may now be given daily and for months, if
necessary in this way, namely, after the lower degree of potency has been used for one or
two weeks in the treatment of chronic disease, advance is made in the same way to higher
degrees, (beginning according to the new dynamization method, taught herewith with the use
of the lowest degrees).

Under these conditions, the smallest doses of the best selected
homoeopathic medicine may be repeated with the best, often with incredible results, at
intervals of fourteen, twelve, ten, eight, seven days, and, where rapidity is requisite,
in chronic diseases resembling cases of acute disease, at still shorter intervals, but in
acute diseases at very much shorter periods - every twenty - four, twelve, eight, four
hours, in the very acutest every hour, up to as often as every five minutes, - in ever
case in proportion to the more or less rapid course of the diseases and of the action of
the medicine employed, as is more distinctly explained in the last note.

It is impractical to repeat the same unchanged dose of a remedy once,
not to mention its frequent repetition (and at short intervals in order not to delay the
cure). The vital principle does not accept such unchanged doses without resistance, that
is, without other symptoms of the medicine to manifest themselves than those similar to
the disease to be cured, because the former dose has already accomplished the expected
change in the vital principle and a second dynamically wholly similar, unchanged dose of
the same medicine no longer finds, therefore, the same conditions of the vital force. The
patient may indeed be made sick in another way by receiving other such unchanged doses,
even sicker than he was, for now only those symptoms of the given remedy remain active
which were not homoeopathic to the original disease, hence no step towards cure can
follow, only a true aggravation of the condition of the patient. But if the succeeding
dose is changed slightly every time, namely potentized somewhat higher (§§ 269-270) then
the vital principle may be altered without difficulty by the same medicine (the sensation
of natural disease diminishing) and thus the cure brought nearer.1

1 We ought not even with the best chosen homoeopathic medicine,
for instance one pellet of the same potency that was beneficial at first, to let the
patient have a second or third dose, taken dry. In the same way, if the medicine was
dissolved in water and the first dose proved beneficial, a second or third and even
smaller dose from the bottle standing undisturbed, even in intervals of a few days, would
prove no longer beneficial, even though the original preparation had been potentized with
ten succussions or as I suggested later with but two succussions in order to obviate this
disadvantage and this according to above reasons. But through modification of every dose
in its dynamiztion degree, as I herewith teach, there exists no offence, even if the doses
be repeated more frequently, even if the medicine be ever so highly potentized with ever
so many succussions. It almost seems as if the best selected homoeopathic remedy could
best extract the morbid disorder from the vital force and in chronic disease to extinguish
the same only if applied in several different forms.

The dose of the same medicine may be repeated several times according
to circumstances, but only so long as until either recovery ensues, or the same remedy
ceases to do good and the rest of the disease, presenting a different group of symptoms,
demands a different homoeopathic remedy.

For this purpose, we potentize anew the medicinal solution1 (with perhaps 8, 10, 12 succussions) from which we give the patient one
or (increasingly) several teaspoonful doses, in long lasting diseases daily or every
second day, in acute diseases every two to six hours and in very urgent cases every hour
or oftener. Thus in chronic diseases, every correctly chosen homoeopathic medicine, even
those whose action is of long duration, may be repeated daily for months with ever
increasing success. If the solution is used up (in seven to fifteen days) it is necessary
to add to the next solution of the same medicine if still indicated one or (though rarely)
several pellets of a higher potency with which we continue so long as the patient
experiences continued improvement without encountering one or another complaint that he
never had before in his life. For if this happens, if the balance of the disease appears
in a group of altered symptoms then another, one more homoeopathically related medicine
must be chosen in place of the last and administered in the same repeated doses, mindful,
however, of modifying the solution of every dose with thorough vigorous succussions, thus
changing its degree of potency and increasing it somewhat. On the other hand, should there
appear during almost daily repetition of the well indicated homoeopathic remedy, towards
the end of the treatment of a chronic disease, so-called (§ 161) homoeopathic
aggravations by which the balance of the morbid symptoms seem to again increase somewhat
(the medicinal disease, similar to the original, now alone persistently manifests itself).
The doses in that case must then be reduced still further and repeated in longer intervals
and possibly stopped several days, in order to see if the convalescence need no further
medicinal aid. The apparent symptoms (Schein - Symptome) caused by the excess of the
homoeopathic medicine will soon disappear and leave undisturbed health in its wake. If
only a small vial say a dram of dilute alcohol is used in the treatment, in which is
contained and dissolved through succussion one globule of the medicine which is to be used
by olfaction every two, three or four days, this also must be thoroughly succussed eight
to ten times before each olfaction.

1

Made in 40, 30, 20, 15 or 8 tablespoons of water with the
addition of some alcohol or a piece of charcoal in order to preserve it. If charcoal is
used, it is suspended by means of a thread in the vial and is taken out when the vial is
succussed. The solution of the medicinal globule (and it is rarely necessary to use more
than one globule) of a thoroughly potentized medicine in a large quantity of water can be
obviated by making a solution in only 7-8 tablespoons of water and after thorough
succussion of the vial take from it one tablespoon and put it in a glass of water
(containing about 7 to 8 spoonfuls), this stirred thoroughly and then given a dose to the
patient. If he is unusually excited and sensitive, a teaspoon of this solution may be put
in a second glass of water, thoroughly stirred and teaspoonful doses or more be given.
There are patients of so great sensitiveness that a third or fourth glass, similarly
prepared, may be necessary. Each such prepared glass must be made fresh daily. the globule
of the high potency is best crushed in a few grains of sugar of milk which the patient can
put in the vial and be dissolved in the requisite quantity of water.

Every medicine prescribed for a case of disease which, in the
course of its action, produces new and troublesome symptoms not appertaining to the
disease to be cured, is not capable of effecting real improvement,1
and cannot be considered as homoeopathically selected; it must, therefore, either, if the
aggravation be considerable, be first partially neutralized as soon as possible by an
antidote before giving the next remedy chosen more accurately according to similarity of
action; or if the troublesome symptoms be not very violent, the next remedy must be given
immediately, in order to take the place of the improperly selected one.2

1 As all experience shows that the dose of the specially suited
homoeopathic medicine can scarcely be prepared too small to effect perceptible
amelioration in the disease for which it is appropriate (§§ 275-278), we should act
injudiciously and hurtfully were we when no improvement, or some, though it be even
slight, aggravation ensues, to repeat or even increase the dose of the same medicine, as
is done in the old system, under the delusion that it was not efficacious on account of
its small quantity (its too small dose). Every aggravation by the production of new
symptoms - when nothing untoward has occurred in the mental or physical regimen -
invariably proves unsuitableness on the part of the medicine formerly given in the case of
disease before us, but never indicates that the dose has been too weak.

2

The well informed and conscientiously careful physician will
never be in a position to require an antidote in his practice if he will begin, as he
should, to give the selected medicine in the smallest possible dose. Like minute doses of
a better chosen remedy will re-establish order throughout.

When, to the observant practitioner who accurately investigates the
state of the disease, it is evident, in urgent cases after the lapse of only six, eight or
twelve hours, that he has made a bad selection in the medicine last given, in that the
patient's state is growing perceptibly, however slightly, worse from hour to hour, by the
occurrence of new symptoms and sufferings, it is not only allowable for him, but it is his
duty to remedy his mistake, by the selection and administration of a homoeopathic medicine
not merely tolerably suitable, but the most appropriate possible for the existing state of
the disease (§ 167).

There are some medicines (e.g., ignatia, also bryonia and rhus, and
sometimes belladonna) whose power of altering man's health consists chiefly in alternating
actions - a kind of primary-action symptoms that are in part opposed to each other. Should
the practitioner find, on prescribing one of these, selected on strict homoeopathic
principles, that no improvement follows, he will in most cases soon effect his object by
giving (in acute diseases, even within a few hours) a fresh and equally small dose of the
same medicine.1

1 As I have more particularly described in the introduction to Ignatia
(in the first volume of the Materia Medica Pura).

But should we find, during the employment of the other medicines in
chronic (psoric) diseases, that the best selected homoeopathic (antipsoric) medicine in
the suitable (minutest) dose does not effect an improvement, this is a sure sign that the
cause that keeps up the disease still persists, and that there is some circumstances in
the mode of life of the patient or in the situation in which he is placed, that must be
removed in order that a permanent cure may ensue.

Among the signs that, in all diseases, especially in such as are of
an acute nature, inform us of a slight commencement of amelioration or aggravation that is
not perceptible to every one, the state of mind and the whole demeanor of the patient are
the most certain and instructive. In the case of ever so slight an improvement we observe
a greater degree of comfort, increased calmness and freedom of the mind, higher spirits -
a kind of return of the natural state. In the case of ever so small a commencement of
aggravation we have, on the contrary, the exact opposite of this: a constrained helpless,
pitiable state of the disposition, of the mind, of the whole demeanor, and of all
gestures, postures and actions, which may be easily perceived on close observation, but
cannot be described in words.1

1 The signs of improvement in the disposition and mind, however,
may be expected only soon after the medicine has been taken when the dose has been
sufficiently minute (i.e., as small as possible), an unnecessary large dose of even the
most suitable homoeopathic medicine acts too violently, and at first produces too great
and too lasting a disturbance of the mind and disposition to allow us soon to perceive the
improvement in them. I must here observe that this so essential rule is chiefly
transgressed by presumptuous tryos in homoeopathy, and by physicians who are converted to
homoeopathy from the ranks of the old school. From old prejudices these persons abhor the
smallest doses of the lowest dilutions of medicine in such cases, and hence they fail to
experience the great advantages and blessings of that mode of proceeding which a
thousandfold experience has shown to be the most salutary; they cannot effect all that
homoeopathy is capable of doing, and hence they have no claim to be considered its
adherents.

The other new or increased symptoms or, on the contrary, the
diminution of the original ones without any addition of new ones, will soon dispel all
doubts from the mind of the attentively observing and investigating practitioner with
regard to the aggravation or amelioration; though there are among patients persons who are
either incapable of giving an account of this amelioration or aggravation, or are
unwilling to confess it.

But even with such individuals we may convince ourselves on this point
by going with them through all the symptoms enumerated in our notes of the disease one by
one, and finding that they complain of no new unusual symptoms in addition to these, and
that none of the old symptoms are worse. If this be the case, and if an improvement in the
disposition and mind have already been observed, the medicine must have effected positive
diminution of the disease, or, if sufficient time have not yet elapsed for this, it will
soon effect it. Now, supposing the remedy is perfectly appropriate, if the improvement
delay too long in making its appearance, this depends either on some error of conduct on
the part of the patient, or on the homoeopathic aggravation produced by medicine lasting
too long (§ 157), consequently on the dose not being small enough.

But even with such individuals we may convince ourselves on this point
by going with them through all the symptoms enumerated in our notes of the disease one by
one, and finding that they complain of no new unusual symptoms in addition to these, and
that none of the old symptoms are worse. If this be the case, and if an improvement in the
disposition and mind have already been observed, the medicine must have effected positive
diminution of the disease, or, if sufficient time have not yet elapsed for this, it will
soon effect it. Now, supposing the remedy is perfectly appropriate, if the improvement
delay too long in making its appearance, this depends either on some error of conduct on
the part of the patient, or on other interfering circumstances.

On the other hand, if the patient mention the occurrence of some fresh
accidents and symptoms of importance - signs that the medicine chosen has not been
strictly homoeopathic - even though he should good-naturedly assure us that he feels
better, we must not believe this assurance, but regard his state as aggravated as it will
soon be perfectly apparent it is.

On the other hand, if the patient mention the occurrence of some fresh
accidents and symptoms of importance - signs that the medicine chosen has not been
strictly homoeopathic - even though he should good-naturedly assure us that he feels
better, as is not infrequently the case in phthisical patients with lung abscess, we must
not believe this assurance, but regard his state as aggravated as it will soon be
perfectly apparent it is.

The true physician will take care to avoid making favorite remedies
of medicines, the employment of which he has, by chance, perhaps found often useful, and
which he has had opportunities of using with good effect. If he do so, some remedies or
rarer use, which would have been more homoeopathically suitable, consequently more
serviceable, will often be neglected.

The true practitioner, moreover, will not in his practice with
mistrustful weakness neglect the employment of those remedies that he may now and then
have employed with bad effects, owing to an erroneous selection (from his own fault,
therefore), or avoid them for other (false) reasons, as that they were unhomoeopathic for
the case of disease before him; he must bear in mind the truth, that of medicinal agents
that one alone invariably deserves the preference in every case of disease which
correspond most accurately by similarity to the totality of the characteristic symptoms,
and that no paltry prejudices should interfere with this serious choice.

Considering the minuteness of the doses necessary and proper in
homoeopathic treatment, we can easily understand that during the treatment everything must
be removed from the diet and regimen which can have any medicinal action, in order that
the small dose may not be overwhelmed and extinguished or disturbed by any foreign
medicinal irritant.1

1 The softest tones of a distant flute that in the still
midnight hours would inspire a tender heart with exalted feelings and dissolve it in
religious ecstasy, are inaudible and powerless amid discordant cries and the noise of day.